Nutrition support in surgical patients with colorectal cancer

AIM: To review the application of nutrition support in patients after surgery for colorectal cancer, and to propose appropriate nutrition strategies. METHODS: A total of 202 consecutive surgical patients admitted to our hospital with a diagnosis of colon cancer or rectal cancer from January 2010 to July 2010, meeting the requirements of Nutrition Risk Screening 2002, were enrolled in our study. Laboratory tests were performed to analyze the nutrition status of each patient, and the clinical outcome variables, including postoperative complications, hospital stay, cost of hospitalization and postoperative outcome, were analyzed. RESULTS: The "non-risk" patients who did not receive postoperative nutrition support had a higher rate of postoperative complications than patients who received postoperative nutrition support (2.40 +/- 1.51 vs 1.23 +/- 0.60, P = 0.000), and had a longer postoperative hospital stay (23.00 +/- 15.84 d vs 15.27 +/- 5.89 d, P = 0.009). There was higher cost of hospitalization for patients who received preoperative total parenteral nutrition (TPN) than for patients who did not receive preoperative TPN (62 713.50 +/- 5070.66 RMB Yuan vs 43178.00 +/- 3596.68 RMB Yuan, P = 0.014). Applying postoperative enteral nutrition significantly shortened postoperative fasting time (5.16 +/- 1.21 d vs 6.40 +/- 1.84 d, P = 0.001) and postoperative hospital stay (11.92 +/- 4.34 d vs 15.77 +/- 6.03 d, P = 0.002). The patients who received postoperative TPN for no less than 7 d had increased serum glucose levels (7.59 +/- 3.57 mmol/L vs 6.48 +/- 1.32 mmol/L, P = 0.006) and cost of hospitalization (47 724.14 +/- 16 945.17 Yuan vs 38 598.73 +/- 8349.79 Yuan, P = 0.000). The patients who received postoperative omega-3 fatty acids had a higher rate of postoperative complications than the patients who did not (1.33 +/- 0.64 vs 1.13 +/- 0.49, P = 0.041). High level of serum glucose was associated with a high risk of postoperative complications of infection. CONCLUSION: Appropriate and moderate nutritional intervention can improve the postoperative outcome of colorectal cancer patients. (C) 2011 Baishideng. All rights reserved.